When can I drive? Return to driving following a wrist fracture: A critical review

Abstract

Introduction: The primary aim of this review was to identify literature that examined factors which influence driving performance following a wrist fracture. Given the known scarcity of research in this area, secondary aims were to detail current practices including the driving habits of patients following a wrist fracture and health professionals' opinions on safe return to driving. Methods: We performed a search in April 2015 using three electronic databases to obtain relevant literature in the English language. Relevant studies including clinical trials, surveys and case reports were reviewed. Results: The search identified 12 relevant studies. Five of these were clinical studies with a crossover design that investigated the driving ability of uninjured individuals with the wrist immobilised in a cast. The remaining were surveybased studies. The clinical trials showed that the presence of a wrist cast reduced driving performance in uninjured individuals. No studies investigated driving performance in individuals with a wrist fracture. The surveys showed that this patient group returns to driving despite perceived safety risks. Inconsistency in expert opinions on whether individuals with a wrist fracture are safe to drive was highlighted. Conclusions: There is evidence to suggest that driving performance is reduced in uninjured individuals when wearing a cast immobilising the wrist; however, the influence of wrist fracture is unknown. This, along with safety implications resulting from current driving behaviours and inconsistent information provided to patients regarding return to driving, highlights the need for further studies to ascertain which factors influence driving performance following wrist fracture.

Driving performance following a wrist fracture: A pilot study using a driving simulator

“…However, consensus is lacking among medical professionals regarding when, and by what criteria individuals are deemed to have adequate driving fitness following DRF. 9 Many patients' seek advice from clinicians regarding return to driving timeframes following their DRF. [10][11][12][13] Driving is a complex task that requires adequate cognitive and physical function, and is also influenced by behavioural factors.…”

“…14 Most studies investigating potential impacts of DRF on fitness to drive have been performed on healthy participants using immobilisation orthoses, but not on actual patients. 10,12,13,15,16 These provide low level evidence that driving when the wrist is immobilised results in worsened driving performance in healthy participants, 9 but potential confounding factors relating to DRF pathology remain poorly understood. There is only one other known study which assessed driving performance in participants with DRF.…”